倒LISS钢板与PFNA治疗老年外侧壁稳定型股骨粗隆间骨折的疗效观察

郭小微　吴进

【摘要】 目的：采用倒打LISS钢板与PFNA治疗老年外侧壁稳定型股骨粗隆间骨折，观察其临床疗效。方法：选取2014年7月-2017年2月本院收治的老年外侧壁稳定型股骨粗隆间骨折患者70例。按照治疗方案不同将其分为倒打LISS钢板组（n=32）和PFNA组（n=38）。比较两组术中出血量、手术时间、平均住院时间、术后并发症、骨折愈合时间和末次随访时Harris评分。结果：两组患者均获得随访，平均随访18.5个月；两组患者术后均未出现切口感染、内置物松动、断裂、骨折不愈合等并发症；PFNA组手术时间、术中出血量、平均住院时间均优于倒打LISS钢板组，比较差异均有统计学意义（P<0.05）；但两组骨折愈合时间、Harris评分比较，差异均无统计学意义（P>0.05）。结论：倒LISS钢板与PFNA治疗老年外侧壁稳定型股骨粗隆间骨折，疗效满意，临床医师可根据患者的实际情况进行综合判断，选择合适的内固定物。

【关键词】 倒置LISS钢板； 股骨粗隆间骨折； 外侧壁； 内固定

Clinical Observation of Inverted LISS Plate and PFNA in Treatment of Lateral Wall Stable Intertrochanteric Fracture of Femur in Elderly Patients/GUO Xiaowei，WU Jin.//Medical Innovation of China，2018，15（16）：0-057

【Abstract】 Objective：To observe the clinical effect of inverted LISS plate and PFNA in treatment of lateral wall stable intertrochanteric fracture of femur in elderly patients.Method：A total of 70 elderly patients with lateral wall stable intertrochanteric fracture of femur admitted to our hospital from July 2014 to February 2017 were selected.According to different treatment regimens，they were divided into inverted LISS plate group（n=32） and PFNA group（n=38）.The amount of intraoperative bleeding，operative time，average hospital stay，postoperative complications，fracture healing time and harris score at the last follow-up between two groups were compared.Result：They were followed up for an average of 18.5 months.No complications such as incision infection，loosening of internal fixation，fracture and nonunion were found in all two groups.The operative time，intraoperative blood loss and average hospitalization time in PFNA group were better than those of inverted LISS plate group，the differences were statistically significant（P<0.05）.However，the fracture healing time and Harris score of two groups were compared，the differences were not statistically significant（P>0.05）.Conclusion：Inverted LISS plate and PFNA are effective in treatment of lateral wall stable intertrochanteric fracture of femur in elderly patients，clinicians can make comprehensive judgments according to the actual situation of patients and select suitable internal fixators.

【Key words】 Inverted LISS plate； Intertrochanteric fracture； Lateral wall； Internal fixation

First-authors address：Southeast Hospital Affiliated to Xiamen University，Zhangzhou 363000，China

doi：10.3969/j.issn.1674-4985.2018.16.016

老年人股骨转子间骨折发病率较高，是最常见的骨折之一。随着老龄化社会的到来，发病率不断上升[1]。其主要死因包括坠积性肺炎、泌尿系感染及下肢深静脉血栓等并发症[2]。早期手术治疗已达成共识[3]，可以降低病死率和致残率[4]。为了减少并发症、提高生活质量，手术治疗股骨粗隆间骨折已成为首选方法。笔者自2014年7月-2017年2月应用倒打LISS与PFNA治疗老年外侧壁稳定型股骨粗隆间骨折70例，療效满意，现报道如下。

1 资料与方法

1.1 一般资料 选取2014年7月-2017年2月本院收治的老年外侧壁稳定型股骨粗隆间骨折患者70例。纳入标准：年龄>65岁；外侧壁稳定型闭合性股骨粗隆间骨折；……